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Contact Information

JESSICA RUSSO REVAND, DMD, MS, PLLC
8987 HERSAND DR STE 3
BURKE, VA22015-1604
 Phone: 703-503-0555
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for JESSICA RUSSO REVAND DMD MS PLLC · (Female)

NPI Number 1669060364
Status Active
Credentials
Entity Individual
Enumeration date 01/07/2021
Last updated 01/07/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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